Explaining a still mostly Unfamiliar Condition

June is Aphasia Awareness Month, and aphasia--which impairs the ability to speak and understand others--is more common than Parkinson’s Disease, cerebral palsy, or muscular dystrophy.

Aphasia is an acquired communication disorder that--while not affecting intelligence--does hamper a person's ability to process language, according to the National Aphasia Association. Most people with aphasia experience difficulty reading and writing.

Roughly 1 million Americans are affected by aphasia, according to the NAA. More than 200,000 Americans acquire the disorder each year.

Shayna Miller, a speech-language pathologist at Mayo Clinic Health System in St. James, said the catalyst for aphasia is usually a stroke, but it can also be caused by a traumatic brain injury (TBI), degenerative diseases, brain tumors, or brain surgery. Speech-language pathologists have myriad standardized tests they use with patients, and a plethora of those can be utilized in examining patients with aphasia. Miller uses those tests, a bedside evaluation, and interviews with the patients’ family and/or caregiver to determine where the patient was from a cognitive standpoint prior to onset of aphasia. There are a variety of different types of aphasia, and they can be moderate, mild, or severe cases.

These levels can also be determined by where the brain injury occurred, Miller said. For example, there’s Broca's aphasia--also known as non-fluent aphasia--where speech output is severely reduced and is limited mainly to short utterances of less than four words.

Vocabulary access is limited and the formation of sounds by persons with Broca's aphasia is often laborious and clumsy, according to the NAA. The person may understand speech relatively well and be able to read, but be limited in writing.

There’s also Wernicke's aphasia--or fluent aphasia--where the ability to grasp the meaning of spoken words is chiefly impaired, Miller said.

Reading and writing are often severely impaired, according to the NAA, but speech can also be problematic. Sentences do not hang together, and irrelevant words intrude.

Whatever the case, the main point is that no two individuals are alike, Miller said. Consequently, therapy has to be individualized.

Moreover, family and caregivers are of paramount importance in treating someone with aphasia, she said. There are myriad tips to better communicate with an aphasia patient.

For example, the sender of the message should make sentences as simple as possible, speak at a slower pace, start with a tête-à-tête rather than large group discussion, eliminate any superfluous background noise, give the person time to talk, don’t correct errors in their speech or finish their sentences, keep them involved in conversations, and/or use alternative communication methods, like drawing, Miller said. Additionally, dealing with aphasia is a longterm game, so it’s pivotal for friends and family members not to become frustrated.

Treatment for aphasia patients is very intense right at the beginning, Miller said, in order to maximize progress. “We like to start as soon as the doctor says it’s ok.”

Global aphasia is the most pernicious diagnoses, she said. It means the therapist must work on two pathways, and progress is much slower. This is also known as “locked-in” syndrome, meaning the patient cannot speak or understand what others are saying. Persons with it can neither read nor write.

Many people with aphasia also have weakness or paralysis of their right leg and right arm, according to the NAA. When a person acquires aphasia, it’s usually due to damage on the left side of the brain, which controls movements on the right side of the body.

Consequently, Miller said she works very closely with the physical therapists at MCHS in St. James. Rarely do patients require help from only her or only a physical therapist.

For the rest of this story, please see the June 26 print edition of the St. James Plaindealer.

Ryan Anderson can be reached at randerson@stjamesnews and followed on Twitter @randerson_ryan

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